骨盆环和髋臼骨折患者院内感染的相关危险因素：一项病例对照研究

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-09-17 DOI:10.1016/j.jcot.2025.103211

Edgar Manuel Bodu-Lamberti , Juanita Fetecua-Chaparro , Juan Olivella Gómez , Camila Karduss-Preciado , Nicoll Navarro Gutierrez , Juan Guillermo Ortiz-Martinez

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引用次数: 0

摘要

背景：探讨骨盆环和髋臼骨折患者发生院内感染的潜在危险因素。方法于2019年1月至2024年5月在哥伦比亚某三级创伤中心进行病例对照研究。选择与骨盆环和髋臼骨折对应的ICD-10编码患者。在应用纳入和排除标准后，最终获得103名符合条件的参与者。采用标准方法对定性和定量变量进行分析。使用交叉表计算95%置信区间的优势比。采用双尾t检验，阈值为0.05，并进行ROC分析。结果研究人群平均年龄为45.3±20.61岁，男性居多（n = 68, 66.01%），道路交通事故居多（n = 53, 51.45%）。总感染率为22.3% (n = 23)，依次为气管炎（n = 9, 8.73%）、导管相关UTI （n = 8, 7.76%）和手术部位感染（n = 7, 6.79%）。在独立预测因子中，表现最好的变量是医院LOS、ISS、肌酐和ICU LOS （auc 0.88-0.78）。入院后10天和34天感染亚组有2例死亡（1.94%）。结论骨盆环和髋臼骨折与高能量创伤、住院时间延长和急性肾衰竭等感染性并发症发生率相关。认识到这些关联可以为早期临床决策和资源分配提供信息，最终改善患者的预后。

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Risk factors associated with nosocomial infections in pelvic ring and acetabular fractures: A case-control study

Background

To identify potential risk factors associated with the development of nosocomial infections in patients with pelvic ring and acetabular fractures.

Methods

A case-control study was conducted at a tertiary trauma centre in Colombia, from January 2019 to May 2024. Patients with ICD-10 codes corresponding to pelvic ring and acetabular fractures were selected. After the application of inclusion and exclusion criteria, a final sample of 103 eligible participants was obtained. Qualitative and quantitative variables were analysed by standard methods. Odds ratios with 95 % confidence intervals were calculated using cross-tabulations. Statistical significance was determined using a two-tailed t-test with a threshold of 0.05 and ROC analyses were implemented.

Results

Mean age of the study population was 45.3 ± 20.61 years, consisting mostly of males (n = 68, 66.01 %) and road traffic accidents (n = 53, 51.45 %). The overall rate of infection was 22.3 % (n = 23), led by tracheitis (n = 9, 8.73 %), catheter associated UTI (n = 8, 7.76 %) and surgical site infection (n = 7, 6.79 %). Among independent predictors, the best performing variables were hospital LOS, ISS, creatinine, and ICU LOS (AUCs 0.88-0.78). Two deaths (1.94 %) were recorded in the infected subgroup at 10 and 34 days after admission.

Conclusion

Pelvic ring and acetabular fractures are linked to high rates of infectious complications, due to high-energy trauma, prolonged hospital stays and acute kidney failure. Recognizing these associations can inform early clinical decision-making and resource allocation, ultimately improving patient outcomes.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.